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NPI Code Detail

MEDICARE: MR. JERRY D BRINDLEY JR. M.D.

MEDICARE:  MR. JERRY D BRINDLEY JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician12214OK
2207P00000XEmergency Medicine Physician12214OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700843224
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JERRY D BRINDLEY JR. M.D.
Provider Business Mailing Address
First Line : 5925 N ANN ARBOR AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73122-7526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5501 N PORTLAND AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-2074
Country : US
Telephone Number : 405-604-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 05/11/2010

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Directions to “ MR. JERRY D BRINDLEY JR. M.D.” Practice Location

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